Physician
Elvin R. Garcia, MD., PA.
Elvin R. Garcia, MD., PA. was paid $302K by Medicaid between Jan 2018 and Nov 2024, across 47 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 38% of everything it billed.
33Billing provider infoELVIN R. GARCIA, MD., PA.
MCALLEN, TX 78501
MCALLEN, TX 78501
33aNPI1801907894assigned 08/31/2006
33bProvider typeRheumatology Physician
28Total paid$302K
24GClaims73,768
24DCodes billed47
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Rheumatology Physician providers in Texas
Rank by total paid#5 of 45
Median peer was paid$12K
This provider vs. median26×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 19,015 | $56K | |
| 2019 | 15,327 | $67K | |
| 2020 | 11,522 | $60K | |
| 2021 | 9,933 | $35K | |
| 2022 | 8,414 | $34K | |
| 2023 | 6,245 | $33K | |
| 2024incomplete | 3,312 | $17K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 38% | 10,420 | 9,762 | $116K |
| J0897 | Injection, denosumab, 1 mg | 23% | 491 | 483 | $68K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 11% | 3,430 | 3,021 | $34K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 10% | 1,936 | 1,905 | $31K |
| 20553 | 3.0% | 2,098 | 2,038 | $9K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.7% | 3,350 | 3,236 | $8K |
| 96375 | Therapeutic injection; each additional sequential IV push | 2.1% | 3,333 | 2,934 | $6K |
| 20610 | 1.8% | 2,792 | 1,654 | $5K | |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 1.7% | 210 | 88 | $5K |
| 96415 | 1.7% | 1,918 | 1,635 | $5K | |
| 96401 | 1.1% | 1,198 | 865 | $3K | |
| 20552 | <1% | 661 | 633 | $3K |
35 more codes
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 427 | $3K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 8,093 | $1K |
| 73600 | <1% | 428 | $718.32 | |
| 73560 | <1% | 774 | $554.46 | |
| 73620 | <1% | 472 | $496.83 | |
| 72100 | <1% | 306 | $423.68 | |
| 73120 | <1% | 632 | $266.22 | |
| 73100 | <1% | 537 | $249.16 | |
| 72070 | <1% | 112 | $123.19 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 40 | $119.20 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,910 | $55.79 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,372 | $53.03 |
| 73521 | <1% | 19 | $43.74 | |
| 86140 | <1% | 5,144 | $42.03 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 3,327 | $30.49 |
| 77080 | <1% | 917 | $29.67 | |
| 72040 | <1% | 93 | $25.20 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 75 | $21.96 |
| 85651 | <1% | 5,290 | $14.85 | |
| 86430 | <1% | 1,223 | $7.00 | |
| 81002 | <1% | 2,000 | $5.84 | |
| 86038 | 0% | 245 | $0.00 | |
| G9359 | Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to treatment with a biologic immune response modifier | 0% | 613 | $0.00 |
| G8399 | Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed | 0% | 200 | $0.00 |
| 3455F | 0% | 182 | $0.00 | |
| 86235 | 0% | 245 | $0.00 | |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 0% | 20 | $0.00 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 70 | $0.00 |
| M1003 | Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic and/or immune response modifier therapy | 0% | 1,086 | $0.00 |
| 1101F | 0% | 44 | $0.00 | |
| 1006F | 0% | 1,601 | $0.00 | |
| 86063 | 0% | 75 | $0.00 | |
| 86225 | 0% | 245 | $0.00 | |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 94 | $0.00 |
| G8542 | Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required | 0% | 20 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGARCIA, ELVIN (PRESIDENT)